Femoral anteversion(in-toe gait)

Femoral anteversion(in-toe gait)
The toes are directed inward during walking making the
child to walk awkwardly &trips over his feet during running.
Causes: below 3 yrs.? forefoot adduction or tibial torsion.
Above 3 yrs.? excessive femoral neck anteversion (hip
internal rotation).
CF: clumsy gait. The child sits in television position &when
standing both patellae directed inward (squinting patellae).
Diagnosis is clinical; to assess the degree of anteversion?
CT to measure the angle between the femoral neck & the
transverse axis of femoral condyles.
?? it usually will correct
Spontaneously with time.
If it persists above the age
of 8 yrs: femoral corrective
osteotomy may be needed.

Protrusio acetabuli
The acetabulum bulges into the pelvic cavity,
either primary or secondary.
Primary type: starts after puberty, usually affects
? with + ve family history. Hip movements are
limited, x-ray shows the inner wall of the acet.
bulges beyond ilioischial line. Later, OA of the
hip develops. ?? THR.
Secondary type: occurs late in life secondary to
osteomalacia, Paget s disease or RA. ?? THR.